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AOAC Laboratory Proficiency Testing Program 2016 Enrollment Application
INSTRUCTIONS: To enroll in the AOAC Laboratory Proficiency Testing Program, complete all sections (Steps 1-5) on this form including payment and/or a purchase order and initial the LPTP Billing Policies. Once completed, click the “SUBMIT” button located on the bottom of page 2 to send electronically or print and fax to 301-924-7087.
STEP 1: PROGRAM SELECTION, RATES AND START DATE a) Select the AOAC Laboratory Proficiency Testing Program(s) your laboratory will enroll in by checking the appropriate box(s) to the leftof listed programs. b) Select your Program Start Date (you must enroll 30 days prior to a scheduled shipment). Prices are effective January 1, 2016 to December 31, 2016.
Proficiency Testing Programs Program Enrollment: 1 Year
Program Start Date CHECK ONE: Must enroll
30 days prior to shipment
Annual Program Cost Includes shipping
M01 Standard Microbiology Program Enrollment includes 4 shipments
January July April October
$4,100.00
M08 Standard Microbiology Program without E. coli O157:H7 Enrollment includes 4 shipments
January July April October
$4,100.00
M09 Standard Microbiology Program without E. coli O157:H7 & Listeria Enrollment includes 4 shipments
January July April October
$4,100.00
M02 Pathogen-Free Microbiology Enrollment includes 4 shipments
February August May November
$3,200.00
M03 Meat Microbiology 1 (Salmonella) Enrollment includes 4 shipments
March September June December
$3,460.00
M04 Meat Microbiology 2 ( E. coli O157:H7) Enrollment includes 4 shipments
March September June December
$3,660.00
M05 Meat Microbiology (Listeria) Enrollment includes 4 shipments
March September June December
$3,660.00
M10 Combination Meat Microbiology (Salmonella, E. coli O157:H7, & Listeria) Enrollment includes 4 shipments
March September June December
$5,540.00
M12 Combination Meat Microbiology (Salmonella & Listeria) Enrollment includes 4 shipments
March September June December
$4,290.00
C01 Meat Chemistry Enrollment includes 4 shipments
March September June December
$2,500.00
C02 Cheese Chemistry Enrollment includes 4 shipments
March September June December
$2,600.00
P01 Pesticide Residues in Fruits & Vegetables Enrollment includes 3 shipments
February October June
$4,360.00
E02 Salmonella in Liquid Egg Enrollment includes 2 shipments
February August
$2,250.00
TOTAL PROGRAM FEES (Check box next to program(s) above to calculate fees)
Check box if shipping to Canada or Mexico*
Wire Transfer Fee: ($25 added when select “Bank Wire Transfer” in STEP 4)
TOTAL DUE:
Your enrollment date is considered to be the date AOAC receives written notification for a new enrollment or renewal in the Laboratory Proficiency Testing Program. If cancellation is received after your enrollment date or your lab is removed for non-payment, AOAC will charge an early termination fee of $150.00 per program and, if applicable, any prorated fees associated with sample shipment(s). See AOAC’s Laboratory Proficiency Testing Billing Policies for full details.
Proficiency Testing Provider Certificate Number 1782.01
*Shipping fees are included in theAnnual Program Cost which isapplicable to continental U.S.
locations only. For Canada and Mexico please add $200.00 USD.
Other international locations email [email protected].
Enrollment Date (today’s date): _____________________________
ProficiencyTestingProgramBillingPolicies_r2 – Rev. 2 (1/13)
AOAC INTERNATIONAL Laboratory Proficiency Testing Program
Billing Policies - FAQs
1. What is my enrollment date?Your enrollment date is considered to be the date AOAC INTERNATIONAL receives written notification for a new enrollment orrenewal in the Laboratory Proficiency Testing Program.
2. Why does my lab need to enroll 30 days prior to a shipment?AOAC provides participant numbers to the test material provider 30 days prior to a scheduled shipment. In order to receive ashipment your lab must be included on this list. Note: new enrollees with no prior credit history with AOAC must prepay. Ifprepayment is not received 30 days prior to the requested start date, your enrollment will start with the next shipment availableupon receipt of payment.
3. What should I do if the primary contact person for the program changes at my lab?It is the labs responsibility to email AOAC at [email protected] and provide us with the name, email, and telephone number of thenew contact person. Please note: Only one email address per lab is allowed.
4. When is my labs payment due?Payment Terms are NET 60. Full payment is due by the Payment Due date located on your invoice. New enrollees with no priorcredit history with AOAC must prepay. AOAC reserves the right to change these terms at any time and request prepayment foraccounts that have a past due credit history.
5. Will AOAC notify me about my labs renewal in the PT program?YES. If you are currently in the PT program, AOAC emails renewal invoices to the primary lab contact 90 days prior to your labsprogram renewal date.
6. What do I need to do once I have received my renewal email?
a. It is required to let AOAC know, in writing, if you will continue in the program by the deadline specified in the email.Reply to the email “Yes” if you will continue in the program or “No” if you do not wish to continue.
b. If you will continue in the program, forward the invoice attached within the email to your Accounts Payable departmentfor a purchase order number, if applicable, and payment.
7. What happens if I do not reply to AOAC’s renewal email by the renewal deadline?Your lab will automatically be removed from the program.
8. What should I do if my lab needs to cancel a shipment?Notify AOAC by email [email protected] at least 30 days prior to a scheduled shipment with your Site ID, lab name, and reason whyyour lab must cancel. If cancellation is received after the 30 day period you are responsible for payment of samples reported tothe test material provider.
9. How do I cancel full participation in the Proficiency Testing Program?Notify AOAC by email [email protected] at least 30 days prior to a scheduled shipment with your Site ID, lab name, and reason whyyour lab must cancel. If cancellation is received after your enrollment date, AOAC will charge an Early Termination Fee of $150.00per program and, if applicable, any prorated fees associated with sample shipment(s) reported or received.
10. What happens if payment has not been made by the time my labs first set of samples are scheduled to ship?Based upon your written notification and commitment of enrollment in the program AOAC will ship your first set of samples;however, AOAC reserves the right to not release your results until payment has been received.
11. My Invoice is Past Due. What should I do?Please contact AOAC immediately at [email protected] to provide payment status or to make payment arrangements, if necessary. Ifpayment is not received within 2 weeks from your invoice due date, your lab will be removed from the program. Also, AOAC willcharge an Early Termination Fee of $150.00 per program and, if applicable, any prorated fees associated with sample shipment(s).
Initial next to each policy
STEP 2: SHIPPING INFORMATION No P.O. Boxes. Only exact street shipping address. Shipping carriers cannot deliver to P.O. Boxes. Please contact the proficiency testing department at 301-924-7077 ext. 150 if shipping outside the continental United States shipping cost vary.
Contact Name:
Laboratory Name:
Street Address:
City: State: Postal Code: Country:
Telephone No.: Fax No.:
Email Address : Hours of Operation:
STEP 3: BILLING INFORMATION
Contact Name:
Laboratory Name:
Street Address:
City: State: Postal Code: Country:
Telephone No.: Fax No.:
Email Address : Hours of Operation:
STEP 4: PAYMENT AND PURCHASE ORDER INFORMATION
Bill my organization by purchase order. Purchase Order No._______________________ (Enclose copy of PO)
Check No. ________________________ (Make payable to AOAC International, US funds only)Remit to: AOAC INTERNATIONAL
2275 Research Blvd, Ste 300Rockville, MD 20850-3250 USA
Visa MasterCard American Express
Credit Card No.____________________________________________ Exp. Date:____________ CSC #___________
Signature of card holder_____________________________________________________________________
Bank wire transfer Fee: $25.00
**For bank wire transfer information please email [email protected]. ** After the wire transfer has been arranged with your bank, fax a copy of the wire transfer with enrollment form to 301-924-7087.
STEP 5: SUBMIT TO AOAC Click the “Submit” button below to send electronically to AOAC INTERNATIONAL.
Or print the enrollment form and send it via fax to (301) 924-7087. If you have questions regarding programs or enrollment please contact AOAC at 301-924-7077 ext. 153 or email [email protected].
FOR AOAC INTERNAL USE ONLY: Site ID: PTP: Invoice No.: NEW Enrollment Other: _____________
Re-enrollment
